Closing in on Week 38 – and “the Spike”

New data confirms returning to school causes problems for kids with asthma

Toronto, ON – New provincial health data confirm what emergency department (ED) personnel in hospitals across Ontario already know – thousands of school children will begin arriving at their doors over the next week or so with asthma flare-ups.

According to the new figures, compiled by the Ontario Asthma Surveillance Information System (OASIS), the 38th week of the year continues to be the peak time for asthma attacks among young people. This phenomenon – known among health-care professionals as the “September Spike” – sends large numbers of school children and their family members to EDs and doctors’ offices in the weeks after the start of the new school year.

“We’ve noticed that the spike isn’t localized to any particular region, as rates throughout Ontario are higher than average during this time period,” said Dr. Teresa To, Senior Scientist at The Hospital for Sick Children (SickKids), Director of OASIS and Adjunct Scientist at the Institute for Clinical Evaluative Sciences (ICES). “The good news, however, is that all signs point to the 2014 September Spike being less severe than previous years.”

It is important to identify contributing factors to the asthma flare-ups in September and take steps to help prevent them. “With these strategies, and better asthma care in general, we’re seeing a gradual but significant decline in the numbers of children being treated for severe asthma symptoms in the back-to-school period,” said Dr. To.

Experts think the cold virus is the main cause of asthma flare-ups in September. When children go back to school, it’s back to close quarters with classmates – and the viruses they carry. Viruses, including the common cold, are the number one cause of asthma flare-ups in children. Children then bring the cold germs home from school and spread them to their parents and younger siblings, explaining why there is a small but significant rise in preschooler and adult asthma flare-ups in late September, right after the school children's spike.

Other possible causes for September flare-ups include: not taking prescribed controller medicine during the summer vacation; the stress of returning to school; allergic triggers at school, such as mould, dust and animal dander on classmates’ clothes; and more pollution as school buses and commuters return in full force after the holidays.

“One in five children in Ontario schools has asthma,” said Carole Madeley, director of respiratory health programs with the Ontario Lung Association. “Despite significant advances in treatment and management, parents and school staff should be aware that asthma is a serious disease that can be fatal.”

Parents of children with asthma can use this Week 38 checklist to reduce their chances of a rush trip to the ED:

Management – make sure you and your child know how to manage his or her asthma, including the proper use of controller and reliever medicines. Answer any questions your child may have about managing asthma at school.

Cleanliness – fight viral infections with regular and thorough hand washing. Teach your child and everyone in your family the correct hand-washing technique, using plenty of soap and running water. If there is no sink, use a hand sanitizer and rub hands for at least 20 seconds.

Triggers – make sure your child knows his or her asthma triggers and how to avoid them.

Action Plan – have your health-care provider give you a written asthma action plan and ask them or a certified respiratory educator how to use it. You can obtain an asthma action plan at www.on.lung.ca or call 1-888-344-LUNG (5864).

Professional help – see your health-care provider if your child's action plan or medicine is not keeping asthma under control and needs adjusting. Work with a certified respiratory educator to learn how to better manage asthma.

Vaccination – make sure your child and family members get the regular seasonal flu shot as soon as it is available.

For information about how to keep your or your child's asthma under control, speak to one of the certified respiratory educators at The Lung Association Lung Health Information Line 1-888-344-LUNG (5864), visit www.on.lung.ca or email info@on.lung.ca.

About the Ontario Lung AssociationThe Lung Association is a registered charity that assists, educates and empowers individuals living with or caring for others with lung disease. The Lung Association provides programs and services to patients and health-care providers, invests in lung research and campaigns for improved policies on lung health. Information about lung health issues is available through the Lung Health Information Line 1-888-344-LUNG (5864) or at info@on.lung.ca.

About OASISThe Ontario Asthma Surveillance Information System (OASIS) was created using health administrative data housed at ICES to provide a population-based longitudinal surveillance system for asthma. OASIS provides information to support asthma-related health planning, surveillance, health economic analysis, policy research and development, public education, public accountability, program evaluation, research, and professional education.